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    BSX
    Earnings call· Sep 2025(Q3 FY25)

    BOSTON SCIENTIFIC CORP BSX

    Oct 22, 2025 Source

    Executive summary

    Boston Scientific Q3 FY25 — Strong Growth Across Portfolio, Raised Full-Year Outlook

    Boston Scientific delivered a strong Q3 FY25, surpassing revenue and EPS guidance, driven by exceptional performance in EP and WATCHMAN, and broad-based growth across its Cardiovascular and MedSurg segments. Despite transient headwinds in EMEA and China VBP pressures, the company raised its full-year outlook, confident in its innovative portfolio and strategic investments in high-growth adjacencies and clinical evidence to sustain above-market growth.

    Highlights

    5

    • Total company organic sales grew 15%, exceeding guidance of 12-14%.

    • Adjusted EPS grew 19% to $0.75, exceeding guidance of $0.70-$0.72.

    • EP sales grew 63%, driving significant market share gains.

    • WATCHMAN sales grew 35%, reflecting accelerated concomitant uptake and continued penetration.

    • Full-year adjusted operating margin expected to expand by approximately 100 basis points.

    Concerns

    5

    • EMEA operational sales declined 2% due to ACURATE valve discontinuation and ERP system backorder.

    • ACURATE valve discontinuation impacted Q3 sales by approximately $50 million.

    • ERP system upgrade resulted in a $30 million backorder in Europe.

    • Axonics performance was below expectations due to commercial disruption.

    • China VBP negatively impacted Peripheral Interventions arterial business.

    Guidance & targets

    22
    CategoryTargetConfidence
    Q4 FY25 Organic Revenue Growth
    11% to 13%
    high materiality
    High
    Full-Year FY25 Organic Revenue Growth
    approximately 15.5%
    high materiality
    High
    Q4 FY25 Adjusted EPS
    $0.77 to $0.79
    high materiality
    High
    Full-Year FY25 Adjusted EPS
    $3.02 to $3.04
    high materiality
    High
    Full-Year FY25 Adjusted Operating Margin Expansion
    approximately 100 basis points
    medium materiality
    High
    Full-Year FY25 Adjusted Tax Rate
    approximately 12.5%
    low materiality
    High
    Full-Year FY25 Operational Tax Rate
    approximately 14%
    low materiality
    High
    Full-Year FY25 Free Cash Flow
    approximately $3.5 billion
    medium materiality
    High
    Full-Year FY25 Adjusted Below-the-Line Expense
    approximately $440 million
    low materiality
    High
    2026-2028 Average Organic Revenue Growth
    10% plus
    high materiality
    High
    2026-2028 Annual Adjusted Operating Margin Expansion
    approximately 50 basis points
    medium materiality
    High
    2026-2028 Annual Free Cash Flow Conversion
    70% to 80%
    medium materiality
    High
    WATCHMAN U.S. Concomitant Procedures
    approximately 25%
    medium materiality
    High
    WATCHMAN U.S. Concomitant Procedures
    potential for that to double
    medium materiality
    Medium
    WATCHMAN Market CAGR
    approximately 20%
    high materiality
    High
    Global PFA Penetration
    50%
    medium materiality
    High
    Global PFA Penetration
    approximately 80%
    medium materiality
    High
    Overall EP Market Growth
    approximately 15%
    medium materiality
    High
    Urology Growth Improvement
    improve
    medium materiality
    Medium
    China Growth
    double-digit growth
    medium materiality
    High
    CRM Business Strength
    strengthen
    medium materiality
    Medium
    ASC AF Ablations (U.S.)
    minimal impact
    low materiality
    Medium

    Segment performance

    21
    SegmentRevenueYoYQoQMargin
    Total Company
    Reported growth versus Q3 2024; operational revenue growth was 19.4% and organic revenue growth was 15.3%, exceeding Q3 guidance range of 12-14%.
    		$5.065 billion20.3%——
    Cardiovascular
    Delivered another outstanding quarter.
    		—23%——
    MedSurg
    Very strong growth.
    		—8%——
    U.S.
    Operational growth, impressive and broad-based across Cardiovascular, Endoscopy, and Neuromodulation.
    		—27%——
    Europe, Middle East & Africa (EMEA)
    Operational decline due to ACURATE valve discontinuation (~$50M impact) and ERP system backorder (~$30M). Excluding these, growth would have been high single digits.
    		—-2%——
    Asia Pac
    Operational growth led by strong double-digit growth in Japan and China.
    		—17%——
    China
    Impressive growth despite substantial VBP in peripheral business, driven by ICTx and EP. NMPA approval for WATCHMAN FLX Pro.
    		—mid-teens——
    Urology
    Organic growth (27% operational). Driven by international business and global Stone Management franchise. Axonics performance below expectations.
    		—5%——
    Endoscopy
    Excellent quarter, driven by double-digit growth in key products including AXIOS, MANTIS, and OverStitch. U.S. grew 11%.
    		—9%——
    Neuromodulation
    Strong quarter. Brain franchise grew low double digits. Pain franchise grew high single digits, with U.S. Intracept growing strong double digits.
    		—9%——
    Peripheral Interventions
    Organic growth (16% operational). Excellent low double-digit growth in U.S. offset by China VBP.
    		—6%——
    Peripheral Interventions - Arterial
    Driven by China VBP.
    		—low single-digit decline——
    Peripheral Interventions - Venous
    Led by Varithena and EKOS.
    		—double-digit growth——
    Peripheral Interventions - Interventional Oncology & Embolization
    Driven by category-leading embolization and cancer therapies portfolio, with notable strength in cryoablation.
    		—double digits——
    Interventional Cardiology
    Includes impact of ACURATE withdrawal. Double-digit growth in coronary therapies (AGENT Drug-Coated Balloon in U.S., imaging catheters globally). U.S. grew 21%.
    		—3%——
    Cardiac Rhythm Management (CRM)
    		—2%——
    CRM - Diagnostics
    Led by LUX ICM device.
    		—low double digits——
    CRM - Core CRM (Low-Voltage)
    Momentum from launch of Conduction System Pacing tools in U.S. and Europe.
    		—low single digits——
    CRM - High-Voltage
    		—low single digits decline——
    WATCHMAN
    Outstanding growth, surpassed 600,000 patients targeted to date. Reflects accelerated concomitant uptake.
    		—35%——
    Electrophysiology (EP)
    Driving continued share gains in the overall EP market. FARAPULSE remains the leading PFA technology.
    		—63%——

    Operational metrics

    23
    Adjusted EPS
    $0.7519% growth
    Q3 FY25

    Exceeded high end of guidance range of $0.70 to $0.72.

    Adjusted Operating Margin
    28%80 bps expansion
    Q3 FY25

    Driven by strong drop-through on top line performance.

    Adjusted Gross Margin
    71%60 bps improvement
    Q3 FY25

    Expected to slightly improve full year versus 2024 despite tariff headwind.

    Foreign Exchange Tailwind
    90 bps
    Q3 FY25

    Favorable versus expectations for reported growth.

    Foreign Exchange Benefit
    $38 million
    Q3 FY25

    Favorable versus expectations for reported growth.

    Acquisitions Contribution to Sales
    420 bps
    Q3 FY25

    Contribution to reported sales.

    Full-Year FY25 Tariff Headwind
    $100 million
    FY25

    Unchanged versus previous expectations.

    Cash on Hand
    $1.275 billion
    as of September 30, 2025
    Gross Debt Leverage Ratio
    2.0x
    as of September 30, 2025
    Legal Reserve
    $306 million
    as of September 30, 2025
    Full-Year FY25 Reported Revenue Growth
    approximately 20%vs 2024
    FY25
    Full-Year FY25 Operational Revenue Growth
    approximately 19%vs 2024
    FY25
    Full-Year FY25 Acquisitions Contribution
    approximately 350 bps
    FY25

    Contribution from closed acquisitions.

    Q4 FY25 Reported Revenue Growth
    14.5% to 16.5%
    Q4 FY25
    Q4 FY25 Operational Revenue Growth
    12.5% to 14.5%
    Q4 FY25
    Q4 FY25 Acquisitions Contribution
    approximately 150 bps
    Q4 FY25

    Contribution from closed acquisitions.

    Full-Year FY25 Foreign Exchange Headwind on Adjusted EPS
    approximately $0.04
    FY25
    WATCHMAN Patients Treated
    600,000+
    to date
    FARAPULSE Patients Treated
    500,000+
    to date
    FARAPULSE Accounts Utilizing Integrated OPAL HDx
    1 in 3
    current

    Utilizing FARAWAVE NAV and OPAL device.

    ACURATE Valve Q3 Sales Impact
    approximately $50 million
    Q3 FY25

    Impact from discontinuation in May '25.

    ERP Backorder Impact
    approximately $30 million
    Q3 FY25

    Impacted a number of businesses in Europe due to ERP system upgrade at Kerkrade distribution center.

    AF Ablations in ASCs (U.S. without CON)
    40%
    future

    Estimated proportion of AF ablations in states not requiring a certificate of need.

    Industry KPIs

    10
    MetricValueDetails
    Tariff impact$100 millionUSD
    System utilization1 in 3accounts
    New product launch rampWATCHMAN FLX Pro
    Procedure volume growth35%%
    FCF conversion leverage guidance2.0xx
    Installed base system placements600,000+patients
    Segment franchise organic growth15.3%%
    Sales force commercial capacity build—
    Indicated addressable patient population5 millionpatients
    Pivotal trial clinical evidence milestonesCompleted enrollment

    Product announcements

    7
    ProductTypeDetails
    WallFlex PLUSlaunch
    WATCHMAN FLX Prolaunch
    ENROUTElaunch
    SEISMIQ IVL for peripheral above-the-knee procedureslaunch
    Conduction System Pacing toolslaunch
    FARAPOINT PFA catheterlaunch
    Contact sensing feature (for FARAPULSE)launch

    Deals & partnerships

    2
    Nalu MedicalExpand portfolio into peripheral nerve pain, complements commercial strength with interventional pain physicians.

    Boston Scientific was a VC investor in Nalu. Nalu has solid Medicare reimbursement and improving commercial payer coverage.

    ElutiaAssets designed to prevent postoperative complications for devices like pacemakers and defibrillators.

    Look forward to expanding reach to more global markets as a complement to Core CRM portfolio.

    Risks & headwinds

    5
    ACURATE Valve DiscontinuationQ3 FY25 onwards

    Approximately $50 million in prior year Q3 sales

    Mitigation: None stated directly, but overall strong growth in other segments offsets.

    ERP System Upgrade BackorderQ3 FY25, expected to improve throughout Q4

    Approximately $30 million impact in Q3

    Mitigation: Team is working to recover, backorder expected to bleed down to acceptable levels by year-end.

    China Volume-Based Procurement (VBP)Ongoing

    Caused low single-digit decline in arterial business

    Mitigation: Offset by new innovation and launches (EP, WATCHMAN FLX Pro, ICTx) and expanding customer coverage.

    Axonics Commercial DisruptionQ3 FY25, expected to improve throughout 2026

    Performance below expectations

    Mitigation: Focus on improving commercial execution, strengthening commercial team, patient activation, and globalization opportunities.

    Tariff HeadwindFY25

    Approximately $100 million for full-year FY25

    Mitigation: Offsets found in other areas of the business to still achieve operating margin expansion.

    What to watch in Q4 FY25

    5

    ERP Backorder Resolution

    By year-end 2025 (Q4 FY25)
    Current~$30 million impact in Q3 FY25
    TargetBackorder bled down to acceptable levels

    Why it matters

    Resolution is key to restoring full sales capacity in EMEA and achieving Q4 guidance.

    We do anticipate this backorder will improve throughout the fourth quarter.

    Q&A highlights

    7

    How does Boston Scientific view WATCHMAN as a key growth driver, and what are the expectations for its growth and dollar contribution, especially with concomitant uptake and upcoming CHAMPION data?

    Management is very pleased with WATCHMAN's performance, calling it a "gem." Concomitant procedures are exceeding expectations (25% of U.S. procedures by year-end 2025, potentially doubling by 2028). The combination of FARAPULSE and WATCHMAN is becoming standard of care. They are comfortable with a 20% market CAGR over the LRP, driven by underpenetrated patient population, globalization (China FLX Pro approval), and pipeline enhancements.

    “We're comfortable with a 20% market CAGR over the LRP, given the strong momentum of WATCHMAN, the underserved patient population that we continue to focus on.”

    asked by Robert Marcus · answered by Michael Mahoney

    2 min read6 chapters

    Detailed Narrative

    01

    Strong Q3 Performance and Raised Outlook

    Boston Scientific reported Q3 FY25 operational sales growth of 19% and organic sales growth of 15%, exceeding guidance. Adjusted EPS of $0.75 also surpassed expectations. This strong performance led to an increase in full-year FY25 organic growth guidance to approximately 15.5% and adjusted EPS guidance to $3.02-$3.04, reflecting confidence in sustained above-market growth.

    02

    Regional Performance and Headwinds

    The U.S. demonstrated impressive 27% operational growth, broad-based across segments. EMEA operational sales declined 2% due to the discontinuation of the ACURATE valve (approx. $50M impact) and a $30M backorder from an ERP system upgrade. Asia Pac grew 17% operationally, with Japan driven by WATCHMAN and EP, and China achieving mid-teens growth despite VBP pressures, supported by new product approvals like WATCHMAN FLX Pro.

    03

    WATCHMAN and EP Market Leadership

    WATCHMAN achieved outstanding 35% growth, surpassing 600,000 patients treated to date, driven by accelerated concomitant uptake and continued market penetration. The company expects 25% of U.S. WATCHMAN procedures to be concomitant by year-end 2025, potentially doubling by 2028. EP sales surged 63%, with FARAPULSE treating over 500,000 patients and maintaining its leadership in PFA technology, with global PFA penetration expected to reach 50% by year-end 2025 and 80% by 2028.

    04

    Strategic Acquisitions and Pipeline

    Boston Scientific closed the acquisition of Elutia BioEnvelope assets and announced the agreement to acquire Nalu Medical, expanding its Neuromodulation portfolio into peripheral nerve pain. The company is also advancing its pipeline with limited launch of SEISMIQ IVL for peripheral procedures by year-end 2025, and expects completion of the FRACTURE trial for coronary IVL in Q1 2026, targeting a U.S. launch in early 2027.

    05

    Margin Expansion and Capital Allocation

    The company achieved 71% adjusted gross margin and 28% adjusted operating margin in Q3, expanding 80 basis points year-over-year, primarily due to favorable product mix. Full-year adjusted operating margin is now expected to expand by approximately 100 basis points, overcoming a $100 million tariff headwind🌐. Capital allocation priorities remain strategic tuck-in M&A, followed by share repurchase, with a gross debt leverage ratio of 2.0x.

    06

    Urology and CRM Business Outlook

    Urology sales grew 27% operational but only 5% organically, with Axonics performance below expectations. However, the company anticipates Urology growth to improve throughout 2026 with new innovation. The CRM business, while growing below market on a dollar basis, is expected to strengthen over the long-range plan with the upcoming DENALI platform refresh and the EMPOWER leadless pacemaker.

    AI-generated summary of the company’s earnings call. Not investment advice.